TY - CHAP M1 - Book, Section TI - Chronic Lymphocytic Leukemia and Associated Disorders A1 - Jain, Nitin A1 - Thompson, Philip A1 - Bueso-Ramos, Carlos A1 - O'Brien, Susan M. A1 - Wierda, William G. A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. A2 - Rieber, Alyssa G. Y1 - 2022 N1 - T2 - The MD Anderson Manual of Medical Oncology, 4e AB - KEY CONCEPTSChronic lymphocytic leukemia (CLL) is the most common leukemia in the United States and has a median age of diagnosis of 70 years.The diagnosis of CLL can be established by peripheral blood flow cytometry in the majority of the patients.Treatment of patients with CLL has evolved from chemoimmunotherapy (CIT) to targeted therapies. Most patients are currently treated with oral targeted therapies. Oral targeted therapies include Bruton tyrosine kinase inhibitors, B-cell lymphoma 2 (BCL2) inhibitors, and phosphoinositide 3-kinase (PI3K) inhibitors. Randomized studies have shown improved progression-free survival (PFS) and overall survival (OS) with oral targeted therapies compared with CIT in CLL.Targeted therapies approved for first-line CLL include ibrutinib, acalabrutinib +/- obinutuzumab, and venetoclax + obinutuzumab. Ibrutinib and acalabrutinib are intended to be given daily continuously. Venetoclax and obinutuzumab is a time-limited treatment approach of 1-year duration.In relapsed CLL, the combination of venetoclax + rituximab has shown improved PFS and OS compared with bendamustine and rituximab. Additional approved therapies for relapsed CLL include ibrutinib and acalabrutinib. The PI3K inhibitors idelalisib and duvelisib are also approved for patients with relapsed CLL.Richter transformation remains an unmet medical need. ­Outcomes with CIT remains dismal with median survival of less than 1 year. There are emerging data with checkpoint inhibition, use of venetoclax-based combination therapies, and chimeric antigen receptor T-cell therapy SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/03/28 UR - hemonc.mhmedical.com/content.aspx?aid=1190832053 ER -